<style>
  #signup_popup {
    -moz-border-radius: 6px;
    background: #eef2f7;
    -webkit-border-radius: 6px;
    border: 1px solid #536376;
    -webkit-box-shadow: rgba(0,0,0,.6) 0px 2px 12px;
    -moz-box-shadow:  rgba(0,0,0,.6) 0px 2px 12px;
    border-radius: 6px;
    padding: 14px;
    width: 700px;
    position: relative;
    height:300px;
    display: none;
  }
  #close_x {
    height: 41px;
    line-height: 1000px;
    position: absolute;
    right: -20px;
    top: -20px;
    width: 40px;
    background: url('<?php echo base_url() . APPPATH ?>themes/welcome/img/close.png') no-repeat;
  }
  .input1{
    width:204px;
    height: 26px;
    background: url('<?php echo base_url() . APPPATH ?>themes/welcome/img/input.png') no-repeat;
    border:none;
    color:#fffffff;
    padding-left:5px;
	margin-bottom:5px;
  }
</style>
<div id="signup_popup">
  <div style="overflow: auto;">    
    <div class="mg10"> 
      <div style="width:315px;float:left;padding-right:41px;height: 278px;border-right: 1px solid #0D6998">
        <div class="font30" style="margin-bottom: 48px;text-align:center;color:#e06604">Become iFree member</div>        
        <script type="text/javascript">
          function ajaxValidationCallbackUser(status, form, json, options){
            if (status === true) {
              window.location='<?php echo site_url('welcome/location')?>';
            }
          }
          jQuery(document).ready(function(){
            jQuery("#form_signup_user").validationEngine({
              ajaxFormValidation: true,
              onAjaxFormComplete: ajaxValidationCallbackUser
            });
          });
        </script>
        <form id="form_signup_user" action="<?php echo site_url('signup/process_ajax') ?>" method="post" style="margin-left:72px">
          <div>
            <input id="display_name" type="text" name="display_name" placeholder="Full name" class="input1 validate[required]"/>
          </div>
          <div>
            <input id="email" type="text" name="email" placeholder="Email" class="input1 validate[required,custom[email]]"/>
          </div>
          <div>
            <input id="password" type="password" name="password" value="" placeholder="Password" class="input1 validate[required]"/>
          </div>
          <div>
            <input id="confirm_pass" type="password" name="confirm_pass" value="" placeholder="Retype password" class="input1 validate[required,equals[password]]"/>
          </div>
          <div class="clearer"></div>
          <div style="margin-top: 10px">
            <div class="cpos_1" style="margin-right: 10px">
              <input type="submit" value="Register" class="button1 btn_disable" name="btn_reg_submit"
                     onclick="$('.formError').remove();"/>
            </div>      
            <div class="mg15">
              <a href="#" onclick="$('#signup_popup').trigger('close');$('#signin').click();">Sign In</a> | 
              <a href="#" onclick="$('#signup_popup').trigger('close');$('#forgot_password').click();">Forgot password</a>
            </div>			
          </div>
        </form>
      </div>
      <div style="width:313px;float:right;margin-top:100px">
        <div class="font30" style="margin-bottom: 20px">
		  <a style="text-decoration:none" href="<?php echo site_url('provider/signup') ?>">Become iFree Provider</a></div>
      </div>
      <div>
		
      </div>
    </div>    
  </div>
  <a id="close_x" class="close sprited" href="#"></a>
</div>